Individual
LYNANN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1200 W TABOR RD, PHILADELPHIA, PA 19141-3019
(215) 820-9949
Mailing address
7547 WHEELER ST, PHILADELPHIA, PA 19153-1323
(215) 820-9949
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003370
PA
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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